University of California San Francisco

Senator Daniel Inouye 722 Hart Building Washington, DC 20510-1102 July 20, 2010 Dear Senator Inouye,

Department of Neurology School of Medicine

Stephen L. Hauser, Chair Department of Neurology, UCSF 505 Parnassus Avenue, M-798 San Francisco, CA 94143-0114 tel: 415-476-1488 fax: 415-476-3428

As Chair of the Department of Neurology at the University of California!San Francisco and former president of the American Neurological Association, I was asked to chair the Institute of M edicine Committee on G ulf W ar and H ealth: H ealth E ffects of Serving in the G ulf W ar, which prepared and published the new IOM report released in April 2010. This IOM report makes findings and recommendations vital to the health and effectiveness of current and future U.S. military forces, in addition to Gulf War veterans. The findings are, in part, these: The chronic multi-symptom illness that affects an estimated 250,000 Gulf War veterans!over one-third of those who served!also affects other military forces. It cannot be ascribed to any psychiatric disorder and is likely the result of genetic and environmental factors, although the data are not strong enough to draw conclusions about what specific chemical, drug, pollutant, or other substance(s) was the cause. The multifaceted illness is a debilitating condition that markedly degrades an individual%shealthandperformance. Given these findings, a coordinated national Gulf War illness research program is needed to employ the best modern science to develop effective treatments, cures and!it is hoped!preventions. Our committee has suggested a path forward to accomplish these goals, recommending a joint effort involving DOD, VA, and the NIH. It is the committee%sbeliefthatwiththisapproach,answerscanbefound. I would respectfully request that you begin this critical wor k immediately by increasing F Y2011 funding for the G ulf W ar illness research program of the D O D Congressionally Directed M edical Research Program. My committee did not identify a specific budget for the CDMRP program, but based on my own experience, and taking into account the $15 million annually available at VA, I believe that the $8 million allocated for DOD in 2010 is not adequate. A DOD allocation of at least $25 million is necessary to address a problem of this scope and consequence. Equally important will be the need to put into place an oversight structure to ensure that only the very best science, relevant to the problems experienced by our veterans, is supported by this appropriation. I very much look forward to speaking with you about these issues and to elaborate upon the IOM findings and recommendations. I will be in W ashington, D. C . on July 27, 2010 to testify at a morning hearing of the House Committee on V eterans A ffairs, Subcommittee on O versight and Investigation, and hope to speak with you via conference call earlier, as I understand your schedule is booked for that afternoon. Thank you for your consideration, and please feel free to contact Mr. L. Blake Lynch in my office at (415) 476-9211 or lynchlb@neurology.ucsf.edu to confirm. Warm regards,

Stephen L. Hauser, M.D. Robert A. F ishman Distinguished Professor and Chair